Abstract
Thoracic sympathectomy is indicated in patients with upper extremity hyperhidrosis. The success of dorsal thoracic sympathectomy is judged by the rate of relief of hyperhidrosis, rate of recurrence and rate of compensatory hyperhidrosis.
Highlights
IntroductionHyperhidrosis is the most important established indication for sympathectomy
There is no definite consensus, it has been suggested that highest success rates occur when interruption is performed for T3 and T4 for palmar hyperhidrosis
For approach to the sympathetic chain in the right chest Port #3 is used by the left robotic arm, and for the sympathetic chain in the left chest Port #3 is used by the right robotic arm
Summary
Hyperhidrosis is the most important established indication for sympathectomy. Surgical sympathectomy for hyperhidrosis has been associated with three areas of controversy: (1) the surgical approach; (2) the technique of sympathectomy; and (3) the extent of sympathectomy. More limited sympathectomy has been associated with lower rates of compensatory hyperhidrosis. There is no definite consensus, it has been suggested that highest success rates occur when interruption is performed for T3 and T4 for palmar hyperhidrosis. T4 and T5 interruption is recommended for palmar and axillary, palmar, axillary, and pedal hyperhidrosis. T3 interruption has been recommended for craniofacial hyperhidrosis[21]
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